New stories, same Stigma: Framing analysis of news articles about people with alcohol-related conditions needing liver transplants

IF 1.8 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

SSM. Qualitative research in health Pub Date : 2025-05-05 DOI:10.1016/j.ssmqr.2025.100567

Whitney Langlee , Divya Kalluri , Rivka Abedon , Aura T. Teles , Janetta Brundage , Po-Hung Chen , Andrew M. Cameron , Hannah C. Sung , Olivia S. Kates

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Abstract

Background

Public stigma surrounding alcohol use disorder (AUD) negatively impacts people with alcohol-related liver disease (ALD) in need of liver transplants (LT). Representations of LT for ALD are socially constructed in part through media, but media on this topic has been underexplored in current research.

Methods

Research team members conducted systematic searches during 7/2022-5/2024 for online, publicly available articles about LT for ALD within leading English-language news sites in the US by monthly visits (n = 24). Using inductive framing analysis, we coded and identified patterns in news articles (n = 42) from 1990 to 2021 to generate frames.

Findings

Our inductive analysis generated 4 main frames: (a) making individual exceptions: good people in a bad group, (b) appealing to societal costs: individual actions putting a strain on society, (c) questioning professionals' judgements: doctors’ discretionary power, and (d) portraying healthcare as a competition: unfair play in a zero-sum game. Media characterized people with ALD as less deserving of liver transplant, but with individual exceptions. Articles described people with “self-induced” illnesses as irresponsible towards themselves, other LT candidates, and society; doctors as “gatekeepers” with discretionary power over how to apply criteria or rules; and the liver transplant waitlist as a competitive zero-sum game in which people with ALD are or should be deprioritized.

Discussion

News articles reflect our society's stigmatization of alcohol-related conditions as well as misconceptions about transplant listing and allocation. Such mischaracterizations can further marginalize stigmatized patients with alcohol-related conditions in need of LTs. We offer recommendations for public communications, including avoiding representations of patients with ALD as exceptions to the norm and contextualizing LT for ALD within the context of public health and social and systemic factors.

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新的故事，同样的耻辱：关于酒精相关疾病患者需要肝脏移植的新闻文章的框架分析

公众对酒精使用障碍（AUD）的耻辱感对需要肝移植（LT）的酒精相关性肝病（ALD）患者产生负面影响。ALD的LT表征部分是通过媒体社会建构的，但在当前的研究中，媒体对这一主题的探索不足。方法研究团队成员在7/2022-5/2024期间，通过每月访问在美国主要英语新闻网站上系统搜索有关ALD的在线公开文章（n = 24）。使用归纳框架分析，我们对1990年至2021年的新闻文章（n = 42）中的模式进行编码和识别，以生成框架。我们的归纳分析产生了4个主要框架：(a)个别例外：坏群体中的好人；(b)呼吁社会成本：个人行为给社会带来压力；(c)质疑专业人士的判断：医生的自由裁量权；(d)将医疗保健描绘成一场竞争：零和游戏中的不公平竞争。媒体认为ALD患者不值得肝移植，但也有个别例外。文章将患有“自我诱发”疾病的人描述为对自己、其他LT候选人和社会不负责任；医生作为“看门人”，对如何应用标准或规则拥有自由裁量权；肝脏移植等待名单是一个竞争的零和游戏，ALD患者是或应该被排除在外。新闻文章反映了我们社会对酒精相关疾病的污名化，以及对移植名单和分配的误解。这种错误的描述可能会进一步边缘化有酒精相关疾病的患者，这些患者需要进行肝移植。我们为公众沟通提供了建议，包括避免将ALD患者视为例外，并在公共卫生、社会和系统因素的背景下将ALD的LT纳入背景。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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